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General NPI Number Information
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NPI Number | 1366410052
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Entity Type | Individual
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Provider Name | STEPHANIE J. WIGGERS M.ED., A.T.,C.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 50 THOMS RUN RD
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-2835
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Country | US
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Telephone | 412-429-2238
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Fax |
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Provider Business Mailing Address
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Address Line | 3325 OLD OAKDALE. RD.
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City | MCDONALD
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State | PA
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Zip | 15057
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Country | US
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Telephone | 412-257-4642
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT002021-A
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License Number State | PA
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